Fetal gender: preferences, predictions, and its impact on women's sexuality, physical activity, and well-being during pregnancy

Background: Parental preferences and predictions regarding fetal sex reflect individual expectations and cultural influences and may affect the emotional experience of pregnancy. At the same time, pregnancy is associated with substantial physical, emotional, and behavioral changes, including alterations in sexual activity, physical activity, and maternal well-being. This study aimed to identify factors associated with parental preferences and predictions regarding fetal sex and to examine pregnancy-related changes in maternal well-being, with particular focus on the possible influence of fetal sex. Methods: This prospective cross-sectional survey included women with singleton pregnancies undergoing first-trimester screening. A total of 320 women participated, and 296 complete questionnaires were included in the final analysis after exclusion of miscarriages and fetal anomalies. Data were collected using a structured questionnaire assessing sociodemographic characteristics, lifestyle factors, obstetric history, parental preferences and predictions regarding fetal sex, sexual behavior, physical activity, and pregnancy-related symptoms. Information about partners was reported by the pregnant women. Statistical analysis was descriptive and exploratory, using chi-square tests and Mann–Whitney U tests, with a significance level of p < 0.05. Results: Most women and partners reported no preference regarding fetal sex (61.8% and 53.4%, respectively). Among those with a stated preference, women more frequently preferred a girl than partners (76.1% vs. 46.4%; p = 0.028). Women with higher education more often preferred a girl (p = 0.003), whereas women with lower education predicted fetal sex more accurately (p = 0.047). Predictions were made more often by women than by partners (74.7% vs. 50.7%; p < 0.001), with prediction accuracy of 48.9% and 55.0%, respectively (p = 0.002). Preference varied significantly according to the sex of previous children (p = 0.001). A vegetarian or vegan diet was associated with a higher proportion of male newborns (p = 0.021), whereas attempts to influence fetal sex were not associated with higher success rates (p = 0.372). After pregnancy onset, 27% of women reported ceasing intercourse, and overall sexual frequency declined significantly (p < 0.001), particularly among women over 30 years of age (p = 0.035). Physical activity decreased especially in women under 30 years of age (p = 0.038). No significant difference was observed between primigravida and multigravida women regarding these changes (p = 0.173). Frequently reported symptoms included low energy (78%), poor sleep (59%), nausea (55%), constipation (49%), increased appetite (46%), and mood swings (45%). Fetal sex had no significant influence on most symptoms. However, concentration problems were more common in pregnancies with female fetuses (p = 0.024), whereas hair loss was more frequent with male fetuses (p = 0.038). Changes in vaginal discharge occurred more often when fetal sex differed from that of previous pregnancies (p = 0.025). Conclusion: Parental preferences and predictions regarding fetal sex differ substantially between mothers and partners and are influenced by education, previous children, and lifestyle factors. Pregnancy is associated with marked changes in sexual behavior, physical activity, and maternal well-being, while fetal sex appears to have only limited influence on most pregnancy-related symptoms. Open discussion of parental expectations and pregnancy-related changes may help identify unrealistic assumptions early and support more individualized and compassionate prenatal counseling.